{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:39:53Z","timestamp":1791819593286,"version":"4.3.4"},"reference-count":13,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:00:00Z","timestamp":1618876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We previously demonstrated an association between tenofovir disoproxil fumarate (TDF) and chronic liver enzyme elevation in the D:A:D study. The objective of the study was to assess changes in alanine aminotransferase (ALT) levels after switching from TDF to tenofovir alafenamide (TAF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included Swiss HIV Cohort Study participants who switched from TDF to TAF with\u00a0two or more ALT values in the 24\u00a0months before and\u00a0two or more values in the 24\u00a0months after replacing TDF with TAF. Individuals with replicating viral hepatitis were excluded. Uni\u2010 and multivariable linear mixed models were used to explore changes in ALT values associated with switching from TDF to TAF, and to assess potential modifying effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1712 participants were included, contributing 6169 ALT values before and 5482 after switching. Median (interquartile range, IQR) age was 50\u00a0(42\u201357) years, and 75% were male. Median (IQR) ALT was 28\u00a0(22\u201338) U\/L before and 24 (19\u201332) U\/L after replacing TDF with TAF. ALT values decreased by 3.7 U\/L (95% confidence interval: 3.2\u20134.2) after the switch. The median drop was larger in patients with chronic ALT elevation (defined as\u00a0two or more elevated values for\u00a0\u2265\u00a06\u00a0months) compared with patients with normal ALT values (17.8 vs. 3.3 U\/L, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). We did not identify any major effect modifications of the ALT change with any of the potential variables studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Replacing TDF with TAF in HIV\u2010monoinfected people led to a significant decrease in ALT values. Findings were not significantly affected by known risk factors for hepatotoxicity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13106","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T21:28:35Z","timestamp":1619040515000},"page":"623-628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Changes in alanine aminotransferase levels after switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) in HIV\u2010positive people without viral hepatitis in the Swiss HIV Cohort Study"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4896-4231","authenticated-orcid":false,"given":"H","family":"Kovari","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Surial","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Bern University Hospital University of Berne Berne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PE","family":"Tarr","sequence":"additional","affiliation":[{"name":"Department of Medicine and Division of Infectious Diseases and Hospital Epidemiology Kantonsspital Baselland University of Basel Bruderholz Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Cavassini","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University Hospital Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Calmy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University Hospital Geneva University of Geneva Geneva 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Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Ledergerber","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Swiss HIV Cohort Study","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw009"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001018"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00348-5"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4454-9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp321"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.3.716-723.2002"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0166-3542(01)00210-8"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1423-0127-20-61"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e3283473405"},{"key":"e_1_2_7_11_1","first-page":"1569","article-title":"Nonalcoholic steatohepatitis and hepatic fibrosis in HIV\u20101\u2010monoinfected adults with elevated aminotransferase levels on antiretroviral therapy","volume":"60","author":"Morse CG","year":"2015","journal-title":"Clin Infect Dis"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002541"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002496"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz999"}],"container-title":["HIV 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